Individuals over the age of 55 are likely concerned with their general health insurance plans, ensuring the care, treatments and medications that they need to live their lives comfortably are covered.
But, what about dental insurance? Although we know how important it is to care for our teeth and gums, why are they considered as less of a priority?
Oral health is always essential — but even more so as we age. Seniors should be able to practice proper dental care without concern about cost. Below we discuss what is covered by dental insurance, the various plans available and how much dental insurance costs for seniors.
Dental insurance overview
Dental insurance, while somewhat similar to regular health insurance, has some specific differences. Enrolling in a dental insurance plan means you pay a monthly premium that typically covers preventative care and emergencies in full, as well as a deductible you must meet for more extensive treatments and procedures.
But dental insurance differs from traditional insurance in terms of monthly costs, how much coverage is provided and how the coverage works (all of which we get into later in this article).
Does Medicare cover dental insurance?
Only a Medicare Advantage Plan (Part C) covers dental services, although others may cover emergency dental work during a hospital stay. Seniors on Medicare Parts A and B will need a separate dental insurance plan in order to cover cleanings, X-rays and other oral health services.
Why is dental insurance important for seniors?
Oral health goes beyond the condition of your teeth; it also affects overall health and well-being. Missing, damaged teeth and unhealthy gums may affect your speech, your ability to eat and increase your risk for diabetes, stroke and heart attack. Further, dental needs may increase with age, as certain medications can negatively impact gum and tooth health.
Because of these risks, it’s critical for everyone, especially seniors, to visit their dentist regularly for cleanings and exams. By enrolling in a dental insurance plan, you don’t have to avoid the dentist for fear of how much it will cost.
What types of dental plans are available to seniors?
Like with general health insurance, navigating different dental insurance plans can be complicated and confusing. Various options exist for seniors, including the below.
Preferred Provider Organizations (PPOs) have a network of dentists who provide a wide range of services for a set fee, which may lead to reduced fees. However, the downside is that there’s also a chance that certain out-of-network practitioners charge less. For most dental PPOs, you’ll have to pay out of pocket for certain covered services until you meet your deductible. Once you’ve met that deductible, coinsurance — the amount you and your plan share for services — will kick in.
For a monthly premium, Health Maintenance Organizations (HMOs) focus on preventative care and pay in-network dentists a set monthly fee per patient. Those dentists then provide services at a low or no cost. HMO plans have no deductible but do not reimburse patients for services. If you need specialized treatment, your primary dentist will have to submit a referral.
Indemnity plans require a patient to pay for a dental service, then submit the receipt to their insurance carrier for reimbursement. Depending on the specifics of the plan, patients may be reimbursed for either a portion or the entire qualified dental expense. The amount covered varies between carriers and plans, but generally indemnity plans don’t have any network restrictions, meaning patients can see whatever dentist they want. Enrollees in an indemnity plan will pay a monthly premium and deductible.
What’s covered by dental insurance for seniors?
Services covered by a dental insurance plan varies, but the following are typically eligible for coverage:
- Two exams and cleanings per year
- Annual X-rays
- Cavity fillings
- Root canal surgeries
- Tooth extractions
If you opt for a comprehensive or full coverage plan, you may also have these treatments covered:
- Orthodontics: procedures to correct a misaligned bite
- Periodontics: treatment for gum disease, or dental implants
- Prosthodontics: prosthetics to restore or replace missing teeth (e.g., dentures)
How much does dental insurance cost for seniors?
Like most insurance plans, the cost of dental insurance includes a monthly premium, as well as a deductible, copay and coinsurance. Each will vary based on where you live and the specifics of your plan.
Most dental insurance plans also have a cap for how much they will cover in a 12-month period, after which the patient is responsible for paying 100% of the cost for care.
Below we compare some of the top dental plans:
Delta Dental - Elite 1000
Monthly Premium: $36.01
Annual Maximum: $1,000
Waiting Period: 6 months
Renaissance Dental & Vision Max Essentials
Monthly Premium: $35.78
Annual Maximum: $750
Waiting Period: 6 months
Spirit Dental & Vision Secure Network
Monthly Premium: $31.63
Annual Maximum: $1,250
Waiting Period: None
Prices found on DirectBenefits.com.
So, should seniors buy dental insurance?
In closing, the cost savings dental insurance provides far outweigh the risk for health issues and sizable bills from your dentist. Seniors should consider their options to find the best plan and reduce out-of-pocket costs.
Explore your options through the Direct Benefits Marketplace.